Modeling Floor Effects in Standardized Vocabulary Test Scores in a Sample of Low SES Hispanic Preschool Children under the Multilevel Structural Equation Modeling Framework

Relationships between achievement goals and doping in cycling: Exploring the mediating role of athlete burnout

Doping remains a pressing issue in competitive sport. This study investigated the relationships between achievement goals and doping by examining the mediating role of athlete burnout. French competitive cyclists (N = 251, Mage = 24.95, SD = 9.85) completed a survey measuring 2 × 2 achievement goals, burnout (i.e. physical exhaustion, reduced accomplishment, negative feelings towards sport, cognitive weariness), doping attitudes and likelihood. Structural equation modelling revealed that performance-approach goals were negatively related to each dimension of burnout and to doping likelihood with a total effect (β = -.10; p < .05). A significant total effect (β = .23; p < .05), as well as direct (β = .17; p < .05) and indirect through the mediating role of cognitive weariness (β = .06, 95% CI = [0.025, 0.601]) were observed between performance-avoidance goals and doping attitudes. The model explained 11.9% of the doping likelihood variance. Burnout may play a key role in understanding the relationships between achievement goals and doping. Considering both athletes' achievement goals and burnout thus appear as crucial for anti-doping efforts. Therefore, developing mental health interventions should be prioritized. Further experimental and longitudinal research is necessary to establish the temporal and causal effects of these relationships.

Does Nonlinguistic Segmentation Predict Literacy in Second Language Education? Statistical Learning in Ivorian Primary Schools

Statistical learning (SL) is a learning mechanism that does not directly depend on knowledge of a language, but predicts language and literacy outcomes for children and adults. Research linking SL and literacy has not addressed children who first learn to read in their second language (L2), common in primary schools worldwide. Several studies have linked SL with childhood literacy in Australia, China, Europe, and the U.S., and we pre-registered an adaptation for Côte d'Ivoire, where students are educated in French and speak a local language at home. Recruiting 117 sixth-graders from primary schools in several villages, we tested for correlations >0.3 between SL and literacy with 80-90% power. We found no evidence for these correlations, but visual SL was correlated with L2 phonological awareness. Although this finding may suggest a role of SL in emergent L2 skills, it underscores the need to include L2 acquisition contexts in literacy research.

Cognitive Aging in Same- and Different-Sex Relationships: Comparing Age of Diagnosis and Rate of Cognitive Decline in the Health and Retirement Study

INTRODUCTION

The ongoing marginalization of lesbian, gay, and bisexual people has been hypothesized to produce poorer late-in-life cognitive outcomes, according to mechanisms posited by minority stress and allostatic load theories. Yet the existence of those outcomes remains understudied, and results of existing studies have been contradictory. Using a population-based longitudinal aging study, this paper will compare age at diagnosis of Alzheimer's disease (AD) or a related dementia and rates of cognitive decline between participants in same-sex relationships (SSRs) and different-sex relationships (DSRs).

METHODS

The study used longitudinal cognitive-health data from the Health and Retirement Study (HRS; 1998-2018; N = 26,344) to analyze the onset of cognitive impairment and AD/dementia and the rates of cognitive change between participants in SSRs and those in DSRs. We hypothesized that SSR participants would have worse overall cognitive functioning in old age and would experience earlier onset of cognitive impairment. Using multiple regression, we compared the ages at which participants in SSRs and DSRs first reported AD or dementia diagnoses and the ages at which they first scored below cutoffs for cognitive impairment, not dementia (CIND) and possible dementia as determined using the cognitive assessment. The study then compared rates of cognitive decline over time across the SSR and DSR groups, including stratified analyses by education, race/ethnicity, wealth, and sex/gender.

RESULTS

Participants in SSRs reported dementia diagnoses (β = -12.346; p = 0.001), crossed the threshold into CIND (β = -8.815; p < 0.001) and possible dementia (β = -13.388; p < 0.001) at a younger age than participants in DSRs. When adjusted for covariates, participants in SSRs also had lower cognition at baseline (β = 0.745; p = 0.003), though having slower rates of cognitive decline when SSR was interacted with time (β = 0.066; p = 0.003). In separate analyses, cognitive differences for SSR participants were only found in participants without undergraduate degrees, with below-median household incomes, and women.

CONCLUSION

Our findings support theories suggesting that marginalization and stigma cause premature cognitive impairment. Findings also suggest that higher education might mitigate the adverse effects of sexuality-minority status on cognitive aging. Results do not support these theories' claims of more rapid cognitive decline; the lower slopes of cognitive decline with time are compatible with the possibility of slower rates of decline for aging individuals in SSRs.

Inclusion of Individuals With Neurodevelopmental Disorders in Norm-Referenced Language Assessments

Standardized, norm-referenced language assessment tools are used for a variety of purposes, including in education, clinical practice, and research. Unfortunately, norm-referenced language assessment tools can demonstrate floor effects (i.e., a large percentage of individuals scoring at or near the lowest limit of the assessment tool) when used with some groups with neurodevelopmental disorders (NDDs), such as individuals with intellectual disability and neurogenetic syndromes. Without variability at the lower end of these assessment tools, professionals cannot accurately measure language strengths and difficulties within or across individuals. This lack of variability may be tied to poor representation of individuals with NDDs in normative samples. Therefore, the purpose of this study was to identify and examine common standardized, norm-referenced language assessment tools to report the representation of individuals with NDDs in normative samples and the range of standard/index scores provided. A systematic search identified 57 assessment tools that met inclusion criteria. Coding of the assessment manuals identified that most assessment tools included a “disability” or “exceptionality” group in their normative sample. However, the total number of individuals in these groups and the number of individuals with specific NDDs was small. Further, the characteristics of these groups (e.g., demographic information; disability type) were often poorly defined. The floor standard/index scores of most assessment tools were in the 40s or 50s. Only four assessment tools provided a standard score lower than 40. Findings of this study can assist clinicians, educators, and researchers in their selections of norm-referenced assessment tools when working with individuals with NDDs.

Psychometric properties of the EQ-5D-3L in South Australia: a multi-method non-preference-based validation study

OBJECTIVE

Although HRQoL tools such as the EQ-5D-3L are significant in determining health status, these measures have not been validated in general populations in Australia. This study aims to psychometrically validate the EQ-5D-3L in a large population sample in Australia for the first time.

METHODS

The EQ-5D-3L was included in the Dental Care and Oral Health study (DCOHS), conducted in a South Australian population sample. The participants were 23-91 years old, and 44.1% were male. The EQ-5D-3L was responded to on a three-point rating scale ("none"/"no", "some" and "extremely"/"unable"/"confined"). We employed the area under the receiver operating characteristic curve (AUROC) to evaluate whether the EQ-5D-3L total score could identify participants with diagnosed diseases and mental health disorders. Psychometric validation of the EQ-5D-3L investigated dimensionality with Exploratory Graph Analysis, model fit, floor/ceiling effects and criterion validity.

RESULTS

The EQ-5D-3L comprised two dimensions, Activities and Symptoms. According to Root Mean Squared Error of Approximation (RMSEA) (<.05) and Comparative Fit Index (CFI) (>.950), the 2-dimensional structure showed excellent model fit with good reliability for the Activities subscale (Ωc = 0.80-95% CI [0.77, 0.83]), and poor reliability for the Symptom subscale (Ωc = 0.56-95% CI [0.53, 0.58]). The EQ-5D-3L showed adequate reliability (Ωc = 0.70-95% CI [0.67, 0.72]). The EQ-5D-3L showed good discrimination for diagnosed diseases (ranging from 64.3% to 86.3%). Floor/ceiling effects were observed across all items. The EQ-5D-3L total score discriminated between respondents who were experiencing health conditions (e.g. cancer, cardiovascular disease, stroke) from healthy individuals.

DISCUSSION

Despite the ceiling effects, the EQ-5D-3L displayed good psychometric properties as an HRQoL measure and discriminated between health states in the general South Australian population. Further research should investigate the psychometric properties of the EQ-5D-5L in South Australia and whether an increased number of response categories can mitigate the observed ceiling effects.

School Readiness in Language-Minority Dual Language Learners in Japan: Language, Executive Function, and Theory of Mind

The present study investigated school readiness in Brazilian (Portuguese-Japanese dual language learner or DLL) 5-year-olds in Japan (1) by examining their language skills, executive function (EF), and theory of mind (ToM) in comparison to their monolingual peers and (2) by investigating the developmental relations between these three skills. DLLs scored lower than monolinguals in Japanese language skills, specifically in receptive vocabulary and the understanding of complement clauses in Japanese. DLLs and monolinguals performed similarly in EF, particularly in inhibitory control tasks measuring interference suppression and response inhibition. However, monolinguals outperformed DLLs in ToM tasks assessing false belief understanding. Finally, DLLs' interference suppression and understanding of complement clauses were both positively related to their false belief understanding. In conclusion, DLLs had school readiness difficulties in Japanese language skills and ToM, but not in EF, compared to their Japanese monolingual peers. Furthermore, the positive relationship of language and EF skills with ToM development, which is commonly reported in monolingual children, extended to an understudied population of DLLs in this study.

Analysis of change in patient-reported outcome measures with floor and ceiling effects using the multilevel Tobit model: a simulation study and an example from a National Joint Register using body mass index and the Oxford Hip Score

OBJECTIVES

This study has three objectives. (1) Investigate the association between body mass index (BMI) and the efficacy of primary hip replacement using a patient-reported outcome measure (PROMs) with a measurement floor and ceiling, (2) Explore the performance of different estimation methods to estimate change in PROMs score following surgery using a simulation study and real word data where data has measurement floors and ceilings and (3) Lastly, develop guidance for practising researchers on the analysis of PROMs in the presence of floor and ceiling effects.

DESIGN

Simulation study and prospective national medical device register.

SETTING

National Register of Joint Replacement and Medical Devices.

METHODS

Using a Monte Carlo simulation study and data from a national joint replacement register (162 513 patients with pre- and post-surgery PROMs), we investigate simple approaches for the analysis of outcomes with floor and ceiling effects that are measured at two occasions: linear and Tobit regression (baseline adjusted analysis of covariance, change-score analysis, post-score analysis) in addition to linear and multilevel Tobit models.

PRIMARY OUTCOME

The primary outcome of interest is change in PROMs from pre-surgery to 6 months post-surgery.

RESULTS

Analysis of data with floor and ceiling effects with models that fail to account for these features induce substantial bias. Single-level Tobit models only correct for floor or ceiling effects when the exposure of interest is not associated with the baseline score. In observational data scenarios, only multilevel Tobit models are capable of providing unbiased inferences.

CONCLUSIONS

Inferences from pre- post-studies that fail to account for floor and ceiling effects may induce spurious associations with substantial risk of bias. Multilevel Tobit models indicate the efficacy of total hip replacement is independent of BMI. Restricting access to total hip replacement based on a patients BMI can not be supported by the data.

Robustness of statistical methods when measure is affected by ceiling and/or floor effect

GOALS AND METHODS

A simulation study investigated how ceiling and floor effect (CFE) affect the performance of Welch's t-test, F-test, Mann-Whitney test, Kruskal-Wallis test, Scheirer-Ray-Hare-test, trimmed t-test, Bayesian t-test, and the "two one-sided tests" equivalence testing procedure. The effect of CFE on the estimate of group difference and on its confidence interval, and on Cohen's d and on its confidence interval was also evaluated. In addition, the parametric methods were applied to data transformed with log or logit function and the performance was evaluated. The notion of essential maximum from abstract measurement theory is used to formally define CFE and the principle of maximum entropy was used to derive probability distributions with essential maximum/minimum. These distributions allow the manipulation of the magnitude of CFE through a parameter. Beta, Gamma, Beta prime and Beta-binomial distributions were obtained in this way with the CFE parameter corresponding to the logarithm of the geometric mean. Wald distribution and ordered logistic regression were also included in the study due to their measure-theoretic connection to CFE, even though these models lack essential minimum/maximum. Performance in two-group, three-group and 2 × 2 factor design scenarios was investigated by fixing the group differences in terms of CFE parameter and by adjusting the base level of CFE.

RESULTS AND CONCLUSIONS

In general, bias and uncertainty increased with CFE. Most problematic were occasional instances of biased inference which became more certain and more biased as the magnitude of CFE increased. The bias affected the estimate of group difference, the estimate of Cohen's d and the decisions of the equivalence testing methods. Statistical methods worked best with transformed data, albeit this depended on the match between the choice of transformation and the type of CFE. Log transform worked well with Gamma and Beta prime distribution while logit transform worked well with Beta distribution. Rank-based tests showed best performance with discrete data, but it was demonstrated that even there a model derived with measurement-theoretic principles may show superior performance. Trimmed t-test showed poor performance. In the factor design, CFE prevented the detection of main effects as well as the detection of interaction. Irrespective of CFE, F-test misidentified main effects and interactions on multiple occasions. Five different constellations of main effect and interactions were investigated for each probability distribution, and weaknesses of each statistical method were identified and reported. As part of the discussion, the use of generalized linear models based on abstract measurement theory is recommended to counter CFE. Furthermore, the necessity of measure validation/calibration studies to obtain the necessary knowledge of CFE to design and select an appropriate statistical tool, is stressed.